Provider Demographics
NPI:1326423799
Name:GOPAUL, SHALINI K (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHALINI
Middle Name:K
Last Name:GOPAUL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13511 FOCH BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SOUTH OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11420-2227
Mailing Address - Country:US
Mailing Address - Phone:917-969-2064
Mailing Address - Fax:
Practice Address - Street 1:13511 FOCH BLVD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SOUTH OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11420-2227
Practice Address - Country:US
Practice Address - Phone:917-969-2064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY678139-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse